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Medical Coding News Archives

HHS Incentive Program Aims for Better Health, Lower Costs

April 1, 2011:

A new $100 million program enables states to provide various incentives, financial and otherwise, to Medicaid beneficiaries in an effort to improve personal health and decrease chronic health conditions in the long term.

The Department of Health and Human Services, which announced the program, holds that an important goal in achieving healthy lifestyles is to encourage individuals to make better choices regarding diet and exercise. Quitting smoking and losing weight, for instance, can prevent such chronic conditions as heart disease, diabetes, and cancer.

This new initiative will allow states to apply to the Centers for Medicare and Medicaid Services (CMS) for Affordable Care Act grants for programs that help Medicaid beneficiaries make better lifestyle choices. CMS is encouraging each state to participate in such programs with incentives ranging from direct cash rewards, retail gift cards, and services not typically covered under the Medicaid program.

CMS Administrator Donald Berwick, M.D., indicates that improved individual health can in turn lower the national cost of health care. Research on previous programs with financial incentives indicates that the positive effect they have on people’s lifestyle choices and preventive care is short-term. This latest program will seek out ways to achieve long-term changes in health goals.

Currently the initiative is focused on the “most critical chronic conditions” in the United States today, such as:

Tobacco use

Obesity

Risk factors for heart disease

Diabetes

These conditions account for high mortality and morbidity rates that are largely preventable and are major contributors to the rising cost of health care in this country.